It started with a faint. Javier Miranda, a generally healthy 69-year-old man living in Venezuela, attributes his episode of dizziness to the summer heat and humidity. His only child, Andres Miranda, is a physician whose intuition tells him something is seriously wrong with his father. The doctor obtains blood work and schedules a CT scan and MRI of the brain for Javier. The medical work-up reveals rapidly progressing lung cancer with metastases to the brain. Violating his credo of complete honesty with patients, Dr. Miranda lies to his father and reassures him instead. Dr. Miranda's mother died when he was just 10 years old. Now his father's remaining lifespan has dwindled to a couple of months. The doctor must find a way to break the bad news to his dad.

Meanwhile, Dr. Miranda receives multiple messages - phone calls, e-mails, and letters - from a difficult and persistent patient. Ernesto Duran suffers from dizzy spells and multiple other symptoms. It could be panic disorder or maybe Ernesto is a hypochondriac. Dr. Miranda instructs his office secretary, Karina, to deal with these communications and remind the patient that there is nothing more that can be done for him. When Ernesto admits he is stalking the doctor, Karina worries. Pretending to be Dr. Miranda, she begins corresponding with Ernesto via e-mail. Before long, Karina develops symptoms similar to Ernesto's and experiences empathy for him.

When his physician-son finally summons the courage to announce the terminal diagnosis, everything changes for Javier - his mood, personal relationships, and awareness of his body's metamorphosis. He perceives the smell of rot associated with his physical deterioration. Dr. Miranda's frame of mind also changes as he copes with his father's impending death. Javier's deathbed request is simply for his son to shatter the terrible silence by talking about the two of them.

Doctor Hanray, a PhD physicist, is an old man, apparently ill with radiation sickness, who visits his ancestral home in the present, or near past (post WWII and post atomic bomb development and detonation). He has to obtain permission from the guards who have turned his small village into a "reservation" in order to visit his parents' graves. He is greeted with military brusqueness at first until they realize who he is and then treat him with honor as one of the developers of the atomic bomb, an honor that makes him "wince" (his word) internally whenever this fact is mentioned.

While looking around and trying to get his childhood bearings, despite the absence of landmarks with all the new building and destruction of the old, Dr. Hanray spots a young lad - age 14 - coming up the road. It is he as his younger self. The younger Dr. Hanray takes him home where he meets his mother and physician father. He wishes to convince his younger self not to go into science, as his father says is his wish, clearly in order to sway the future development of the atomic bomb. He is met with a cold reception - but civil - by his mother, father and younger self until Doxy, their dog, comes in and recognizes the identity of Dr. Hanray elder with the boy. Doxy's warmth turns the mood around but in the end Dr. Hanray is unsuccessful in dissuading the boy and he leaves only to wake up on the ground outside his deserted home.

In Illness as Narrative, Ann Jurecic thoughtfully examines the unruly questions that personal accounts of illness pose to literary studies: What is the role of criticism in responding to literature about suffering? Does the shared vulnerability of living in a body, which stories of illness intimately expose, justify empathic readings? What is the place of skepticism in responding to stories of suffering? Does whether or how we read illness narratives matter? Jurecic's questions entice discussion at an interesting cultural moment. The numbers of memoirs and essays about illness—and their inclusion in medical school and other humanities courses—multiplied from the later decades of the 20th century to the present. However, their increase, and their potential to encourage empathic readings, coincided with dominant literary theories that advocated vigorously skeptical, error-seeking responses to texts and their authors. Jurecic reminds us that Paul Ricoeur called such responses "the hermeneutics of suspicion" (3).

Jurecic's astutely researched, nuanced answers to those questions propose a corrective to the extreme skepticism of "disembodied criticism." Such criticism, she claims, dismisses testimonial writing from "a position of distance and privilege." But her answers also affirm that intellectually "rigorous" responses to texts are central to the critical humanities (15). To further her position, she offers attentive readings of accounts of illness by Virginia Woolf, Reynolds Price, and Jean-Dominique Bauby, as well as the theoretical writing of literary and other scholars. For instance, Jurecic speculates that the condition of a reader's body aligns with his or her responses to texts. In a chapter called "Theory's Aging Body," she observes that as skeptical scholarly readers age—Stephen Greenblatt, Michel Foucault, Judith Butler—they have turned their attention to "illness, vulnerability, and mortality" (93). Jurecic also suggests that a function of criticism is to uncover the cultural conditions that memoirs and essays about illness respond to. Living "at risk" is a recent one. In stories of living with the risk of experiencing a particular illness in the future, potential patients create narratives of uncertainty to discover the "personal meaning of the impersonal statistics" that medical research now regularly delivers (18).

Jurecic also reflects on the ways theorists have understood the possibilities of representing and responding to pain in the varied approaches of philosophers Elaine Scarry, Martha Nussbaum, and Richard Rorty and of anthropologists Jean E. Jackson, Byron Good, and Veena Das. In an exceptionally comprehensive and nuanced reading of Susan Sontag's theoretical, fictional, and journal writing about suffering, Jurecic uncovers Sontag's inconsistent, yet revelatory positions on the human capacity for responding to representations of pain. The chapter on Sontag is enriched by Jurecic's reading of Annie Lebovitz's and David Reiff's responses to Sontag's suffering: in Lebovitz's controversial photographs of Sontag's final days (included in A Photographer's Life: 1990-2005) and Reiff's memoir about his mother's illnesses (Swimming in a Sea of Death).

Illness as Narrative closes with examples of what Jurecic calls reparative writing and reading practices. In the first instance, ill writers such as Jean-Dominique Bauby (The Diving Bell and the Butterfly) both recreate "a more coherent sense of themselves" and dislodge "fixed ideas and narratives" about illness (109). In the second instance, Jurecic outlines the limits of two competing readings of Anne Fadiman's The Spirit Catches You and You Fall Down. One assumes that readers will by nature empathically imagine those who are culturally different from themselves. The other looks skeptically at the assumption that what medical educators call cultural competence can be acquired by reading a book. Jurecic suggests that strategies for reading and teaching informed by Janelle S. Taylor, Eve Kosofsky Sedgwick, and Rita Felski can encourage more complex habits of response, such as Taylor's "'empathic curiosity'" (quoted 122).

Dr. Jennifer White, age 64, is read her rights in a Chicago police station. But how much does the retired orthopedist who specializes in hand surgery really understand? Dr. White has Alzheimer's dementia. Her score of 19 on a mini-mental state examination (MMSE) is consistent with a moderate degree of cognitive impairment. She is questioned about the death of a neighbor, 75-year-old Amanda O'Toole, who lives 3 houses away. Amanda happens to be Dr. White's best friend and the godmother of her daughter. Amanda died at home, the result of head trauma. Four fingers of her right hand were cleanly and expertly chopped off. It seems that Dr. White is genuinely incapable of recalling whether she committed a murder or not. The physician is not charged with the crime but remains a suspect.

Dr. White's memory and mind are no longer reliable. In her lucid moments, she jots down notes in a journal. She dubs the notebook her "Bible of consciousness" [5] and it assists her in filling in the blanks of her past life. Her husband James has died. She has approximately $2.5 million of financial assets. Her two adult children - Mark and Fiona - squabble. Throughout the course of her disease, family secrets are revealed and intimate details are exposed. Relationships fray.

Despite a slew of prescription medications (galantamine, an antipsychotic, an antidepressant, and a benzodiazepine as needed), Dr. White's mental status and behavior deteriorate. Her confusion, wandering, forgetfulness, and episodes of agitation worsen. The story is structured in four sections, based on the residence of the protagonist: First is Dr. White's time in her own home aided by a live-in caregiver, Magdalena. Next is her stay in an assisted living facility. Then she briefly escapes from that place and has a 36 hour adventure of sorts. Finally, Dr. White is incarcerated in a state mental health facility.

Ultimately, the circumstances of Amanda's death are made known. And while Dr. White did not kill her best friend, the surgeon was present at the scene with a scalpel in her hand. Another character was there too.

Large blue circular eyes stare up from this frontal self-portrait. The sclera is visible underneath the eyes, which reflect the same washed blue of the background. This blue is as startling as, and reminiscent of, the green background of a Van Gogh self-portrait. The visage is grimly determined and the mouth a thin-lipped line. Ears are large and the shoulders blend into the background. He is thin and somewhat haggard.

This is an aerial view of a comatose patient being force-fed by a funnel leading directly into her stomach. Surrounding the consultation table are six (identifiable) black-robed supreme judges gleefully pouring nutritious foods (grapes, fish, Quaker Oats, peanut butter, water and 7-Up) into her. Two tiny symbols, the scales of justice and a red-white-and-blue eagle contribute to the otherwise empty courtroom decor.

In the upper right corner, barely visible, is an open door with a "Keep Out" sign dangling from its knob, through which a doctor and nurse peer in. Four tiny red paper-doll figures holding hands, symbolizing the family, are also by this door. Hanging precariously over the patient and consultation table is an ugly, large, bare 25-watt light bulb.

The writer Donald Hall gives us a lyrical armchair view through the windows of his house not only of the New Hampshire landscape, but also of his and his anscestors lives lived in that landscape. His honest and moving account from his 83rd year is captured in the following: "I feel the circles grow smaller, and old age is a ceremony of losses, which is on the whole preferable to dying at forty-seven or fifty-two [the ages his wife Jane Kenyon died and his father died]. When I lament and darken over my diminishments, I accomplish nothing. It's better to sit at the window all day, pleased to watch the birds, barns, and flowers. It is a pleasure to write about what I do" (p.41).

This portrait of the artist's mother was done a few months before her death in 1954. An elderly woman with white, feathery, unkempt hair sits facing the viewer, wearing a plaid wool bath robe. Although the chair is set on a slight diagonal with the picture plane, the impression is one of frontality: the subject faces (confronts) the viewer with a combination of fortitude and vulnerability.

Neel has suggested spiritual and emotional conflict by dividing the face and accentuating the frightened eyes behind large spectacles. The strong geometrical pattern of the bathrobe gives a sense of stability to the form, while simultaneously setting up a contrast with the delicate hands and aged face of the sick woman.

In 1980, four years before her death at age 84, Alice Neel painted her first self-portrait. Grasping her paintbrush, the naked artist looks directly at the viewer without concern for pleasing. Bravely, she invites us to meet her fully in this deeply honest and vulnerable space.

The hard vertical bars of the chair encircle her soft and abundant flesh. One arm is raised in readiness for work, the other hangs limp, mimicking the heavy droop of her breasts and stomach. Eyeglasses hint at frailty yet proclaim her as one who sees. These opposing elements mark her singularity.

'Smut: Two Unseemly Stories' consists of two novellas, 'The Greening of Mrs Donaldson' and 'The Shielding of Mrs Forbes'. Both are slight but well-observed and nimbly narrated stories about sex and manners.

In 'The Greening of Mrs Donaldson', a newly widowed woman has to make ends meet; she takes in lodgers (initially a medical student and her boyfriend) and finds herself employed at a local medical school as a standardized or simulated patient (a patient instructor), joining several other stalwart characters in feigning illnesses and ailments for the educational benefit of training doctors. When her tenants do not have the money to pay their rent, they find another way of reimbursing Mrs Donaldson. 'The Shielding of Mrs Forbes' is about the marriage of vain handsome Graham Forbes to a wealthy, although not particularly beautiful, woman, much to the frustrated dismay of his mother. In both novellas, secrets about sex and surprising erotic arrangments threaten the measured, middle class lives of the Donaldson and Forbes families.